NPI 1205815230 · live from the CMS NPI Registry
Karen E Boullain, RN
Registered Nurse, Registered Nurse First Assistant in Marietta, GA. National Provider Identifier 1205815230, active.
NPI record
| NPI | 1205815230 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, Registered Nurse First Assistant 163WR0006X |
| Practice location | 2900 Delk Rd Se, Suite 700 #166, Marietta, GA 30067 |
| Practice phone | 678-640-7536 |
| Mailing address | 2900 Delk Rd Se, Suite 700 Pmb 166, Marietta, GA 30067 |
| Enumerated | January 9, 2006 |
| Last updated | January 27, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Registered Nurse First Assistant primary | 163WR0006X | RN063260 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.